Nova Scotians who are admitted to the hospital while sick with COVID-19 are no longer being treated in a unit separate from patients who have not contracted the virus.
The province has been moving away from designated COVID-19 units for some time. The last ones closed in mid-July.
It's now using a "care in place" model, meaning all patients will be treated in whichever unit or facility of the hospital that meets their needs, regardless of COVID-19 status.
Patients with COVID-19 are placed in a private room or cohorted with other patients who have the virus or have recently recovered from it, said Dr. Shelly McNeil, senior medical director for COVID planning and implementation for Nova Scotia Health.
Patients with COVID-19 must wear masks when outside of their rooms, and are only allowed to leave their rooms for necessary tests and procedures.
McNeil called it the "gradual evolution" of dealing with COVID-19 in the health care system.
"We're seeing a shift to patients that tend to be complex medically, so they have lots of underlying medical problems, and COVID is tipping them over the edge, so to speak, with regard to other medical problems," McNeil said.
"It might be making their underlying lung disease worse, or their underlying heart disease worse, or other things. So they're not needing the same type of intensive respiratory support that we were seeing in the beginning phases of the pandemic."
The removal of COVID-19 units means there are longer designated beds held for COVID-19 patients. Those beds are instead put into the regular rotation of medicine and hospital services, ideally improving flow for patients through the hospital.
"There's been lots of pressure in the emergency department, high volumes of patients for a whole lot of different problems. So we're still having, of course, significant flow challenges. We're just hoping that in doing this, it streamlines the impact COVID would have on those challenges," she said.
A COVID-19 physician consultation service has been established in each health zone, and is available 24/7, to support clinical decision making for patients with the virus, including whether they need to move to the ICU in cases of severe disease.
The seven-day isolation period for Nova Scotia Health employees who test positive for the virus remains in place, as does the vaccine mandate for health care workers.
McNeil said NSH will continue to monitor the COVID-19 situation and reassess operational plans as needed, which could include bringing back designated COVID-19 units if the situation worsens.
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